The CfWI produces quality intelligence to inform better workforce
planning, that improves people’s lives
Maternity care
pathway workforce
model – testing the
prototype
1
National supply and demand forecasts for the
nursing and midwifery workforces to support
more effective planning
National supply and demand forecasts for the
nursing and midwifery workforces to support
more effective planning
2
Review of the shift of care into primary and
community settings and the implications for the
shape of the nursing workforce
Review of the shift of care into primary and
community settings and the implications for the
shape of the nursing workforce
3
Development of a multidisciplinary workforce
model for the maternity care pathway (MCP)
Development of a multidisciplinary workforce
model for the maternity care pathway (MCP)
The CfWI nursing and
midwifery programme 2012
-13
Developing the
MCP workforce
model
The MCP model is:
• designed for use by providers of
maternity services
• designed to analyse a service’s
maternity workforce along summary
care pathways
• aligned with the proposed new
maternity tariff
• designed to provide analysis about
possible future change scenarios
• an aid to better informed workforce
decision-making
• reliant on data inputted by the service
• Excel-based
• an aid to service comparison.
The maternity care pathway
workforce model - prototype
The MCP model is not:
• a benchmarking tool
• a replacement for other established
tools such as BirthRate+®
• a source of the right answer
• an accounting tool
Benefits include:
• modelling your maternity workforce
based on possible service change
scenarios, for example:
• a change in birth rate
• revisions to NICE guidelines
• a proposed service improvement
• a better understanding of how your staff
are deployed, by care pathway
• linking your decisions about staffing
more closely with the new maternity
tariff.
The maternity care pathway
workforce model - prototype
To use the model:
• commit a small ‘change team’ to
develop and validate your service’s
pathway maps (2 x 3 hour
workshops)
• commit a senior staff member to
lead the process
• commit an information analyst’s
time to support data gathering and
entry.
The model will produce a range of
reports which can be individually
exported.
6
Maternity care pathway
workforce model - benefits
Comments from Heads of midwifery:
‘It will be helpful in presenting the staffing levels for our care pathways
when meeting with our commissioners.’
‘I like the fact that it can work with the new tariff.’
‘It could provide me with better information to include in a business care
to my directors.’
•
Kingston Hospital Trust found, when comparing its transitional care
ward staffing and the general postnatal ward staffing per woman, that
the former had slightly lower levels of staffing. This is being reviewed.
•
University Hospital Southampton carried out an audit to analyse the
level of unscheduled care that was being demanded during the third
trimester, across midwife, admin and obstetrician time. A scenario
describing the staffing of a new, midwife-led triage service is being
developed in order to model this change of care and its staffing
implications.
The MCP
model
8
Maternity care pathway
workforce model – demo
1. Summary care pathway maps: examples from
University Hospital Southampton and Kingston
Hospital Trust.
2. Birthed women data, linked to new tariff.
3. Staff information and maternity roles.
4. Inputting a service’s maternity care activity
information.
5. Examples of reports.
9
Maternity care pathway workforce
model – dissemination
• January – March 2013: national testing with service
leaders and with individual maternity services.
• Prioritised list of improvements to the MCP model
agreed with the Department of Health.
• Final model development and technical testing.*
• Launch and dissemination – MCP model available for
free download from the CfWI website.*
• Review and evaluation.*
Appendix
• Provider profile of
Southampton and
Kingston
• Steps to using the
MCP model
• Screenshots of
model
• Based from the Princess Anne Hospital (PAH): it opened in 1981 and hosts specialist services in obstetrics,
gynaecology, neonatal medicine/surgery and breast care.
• PAH serves Southampton City, which has significant areas of deprivation, as well as the communities around the city and rural, south-west Hampshire (the New Forest). • 2011-12: 6,225 women gave birth.
• Births on three sites as well as at the
woman’s home: the PAH labour ward, the co-located Broadlands Birth Centre and the standalone New Forest Birth Centre. • Workforce includes: 197 full-time
equivalent (FTE) midwives (241
headcount), 52 FTE midwifery support workers, obstetrics staff, nursery nurses, clerical staff, sonographers and nurses.
Provider profile:
University Hospital
Southampton FT
Provider profile:
Kingston Hospital NHS
Trust
• Based from the maternity unit at Kingston Hospital (KH), which opened in 1995. In addition to core services, it hosts specialist services in obstetrics and gynaecology, including a neonatal unit.
• KH serves an area of outer, south-west London including Kingston, Sutton, Merton and Richmond. Although there are pockets of deprivation and fairly high ethnic
diversity, these are among the wealthier London boroughs.
• 2011-12: 5,934 women gave birth. • Births on two sites, as well as at the
woman’s home: the KH labour ward and the co-located, midwife-led Malden Suite. • Workforce includes: 185 FTE midwives,
57 FTE midwifery support
workers/maternity assistants, obstetrics staff, anaesthetists
and ODPs, nursery nurses sonographers and staff nurses.
12 A maternity provider will need to carry out a process to develop summary care pathway maps and assemble the necessary activity and staff timings data. The final model will provide guidance, templates and example workshop outlines to support this.
Elements of data for each care pathway (per woman)
Women birthed data
Care activity Birth activity for a year Frequency of activity Subdivided by care level Staff roles delivering each care activity Subdivided by intrapartum
activity Typical staff time allocation per care
activity
Plus overall staff profile
Once inputted, the model then aggregates the individual care pathway staffing and multiplies this by the birth data to produce an overall staffing profile. This then needs to be matched to the actual staffing profile. Some minor alterations to the pathways information might be required to ensure matching. This tested
profile needs to be saved. It provides the basis for comparison with future change scenarios.
13
Maternity care pathways
Example of
possible
report
design
For further information about the maternity care
pathways workforce model:
[email protected]
Or the nursing and midwifery programme:
[email protected]
Centre for Workforce
Intelligence
209 – 215 Blackfriars Road, London SE1 8NL
General enquiries T +44(0)20 7803 2707 E
